title: Immediate and medium-term outcomes of cryoballoon-based pulmonary vein isolation in patients with paroxysmal and persistent atrial fibrillation: single-centre experience.
abstract: BACKGROUND
  Pulmonary vein (PV) isolation with cryoballoon is a recently developed technique for the treatment of atrial fibrillation (AF) with acceptable mid-term results in terms of the success and safety. The purpose of our study is to identify the periprocedural complications, mid-term success rates and predictors of recurrence after AF ablation with cryoballoon.
  
  
  METHODS
  A total of 236 patients (54% male, mean age 54.6 ± 10.45 years and 79.6% paroxysmal AF) with symptomatic AF underwent PV isolation with cryoballoon due to failure with ≥1 antiarrhythmic drug previously. Procedural success, complications and follow-up data were defined according to recent guidelines.
  
  
  RESULTS
  Acute procedural success rate was 99.5%. Mean procedural and fluoroscopy times were 72.5 ± 5.3 and 14 ± 3.5 min. At a median of 18 (6-27) months follow-up, 80.8% of paroxysmal AF patients and 50.0% of persistent AF patients were free from AF recurrence. In multivariate regression analysis, body mass index (BMI) (hazard ratio (HR), 1.35; 95% confidence interval (CI), 1.18-2.93, p = 0.001), smoking (HR, 2.12; 95% CI, 1.36-6.67, p < 0.001), non-paroxysmal AF (HR, 1.26; 95% CI, 1.12-2.56, p = 0.024), duration of AF (HR, 1.42; 95% CI, 1.18-2.61, p = 0.015), left atrium (LA) diameter (HR, 2.42; 95% CI, 1.64-5.88, p < 0.001) and early AF recurrence (HR, 4.88; 95% CI, 2.86-35.6, p < 0.001) were independent predictors of AF recurrence following cryoablation.
  
  
  CONCLUSIONS
  Our results showed that AF ablation with cryoballoon is effective and safe. Non-paroxysmal AF, duration of AF, smoking, BMI, LA diameter and early recurrence were found to be the most powerful predictors and could be helpful to select patients for appropriate therapeutic strategy.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Levent
authors.initials: L
authors.lastname: Şahiner
authors.forename: Ergün Barış
authors.initials: EB
authors.lastname: Kaya
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D002908:Chronic Disease; D003452:Cryosurgery / Q000706:statistics & numerical data*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult